Effect of Combined Fluoride-Chlorhexidine Mouthrinse on Orthodontic Patients' Oral Health

Objectives: The purpose of current study was to investigate whether combined mouthrinse containing both fluoride and chlorhexidine would improve clinical oral hygiene parameters and could be efficacious in reducing total bacterial level, and cariogenic bacteria. Methods: In this double blind clinical study, 60 fixed orthodontic patients aged 15-25 years who had mild gingivitis were randomly assigned to one of the following 4 mouthrinses groups: 1- Combined fluoride and chlorhexidine, 2- Chlorhexidine 0.12%, 3- Fluoride 0.05%, 4- Placebo. Following baseline examination, the participants were instructed to use the assigned mouthrinse twice daily for 1 min. Their usual oral hygiene procedures were continued. Bleeding index (BI), marginal gingival index (MGI) and plaque index (PI) were determined at baseline (T0) and after 3 weeks of mouthrinsing (T1). Also, supragingival plaque samples were obtained and assessed for total bacterial, lactobacillus, and streptococcus mutans colony counts. Results: BI and MGI: Both combined and chlorhexidine mouthrinses significantly reduced the mean amounts of BI and MGI (P<0.05). Fluoride mouthrinse was less effective than the those two, but more efficient than placebo. PI: combined and chlorhexidine mouthrinses reduced PI significantly (P<0.05) and fluoride and placebo did not improve PI. Total bacterial count: Except placebo, other mouthrinses reduced total bacterial count, but the effect of combined one was significantly better. The order of efficiency was combined>chlorhexidine>Fluoride. Lactobacillus count: Combined one was significantly better than the others. Streptococcus mutans count: All, except placebo reduced colony count. The order of efficiency was combined>chlorhexidine, Fluoride. Chlorhexidine and Fluoride difference was not significant. Conclusions: The new combined mouthrinse had similar to better effects compared to chlorhexidine mouthrinse on improving clinical parameters of orthodontic patients while could take advantage of fluoride. However, further studies are recommended to assess the effect of new combined mouthrinse in reducing white spot lesions.